Rhinoplasty is by far one of the most challenging cosmetic procedures in plastic surgery. The rhinoplasty surgeon must have thorough understanding of the underlying anatomy, the ability to perform nasofacial analysis in order to determine the optimum operative plan, and the ability to execute the right techniques to manipulate cartilage, bone and soft tissue. These skills are tempered with an aesthetically experienced eye in order to achieve a result that blends harmoniously with the rest of the face.
Patients considered appropriate surgical candidates for rhinoplasty are those whose degree of concern about looking better is proportionate to the degree of their deformities. However, there are some patients whose stress and concern aren't congruent with the degree of their nasal deformities. These patients frequently have an expectation level that exceeds the reasonable ability of the operation to gain aesthetic improvement and should be properly assessed by an experienced plastic surgeon. Furthermore, regardless of the degree of deformity, if the level of skill and expertise required to perform the rhinoplasty exceeds the surgeon's ability, that patient should be referred to another surgeon who possesses the amount of required proficiency.
Accurate, systematic, and detailed nasofacial analysis is a critical factor in determining the subsequent rhinoplastay operative plan. The nose must not only be looked at in isolation, but also with respect to the overall appearance of the face, in order to create or maintain total balance and harmony. It is also of crucial importance to evaluate the patient thoroughly for any concomitant facial asymmetries so that the patient gains a better understanding of exactly what was present before any operative intervention. This detailed analysis is crucial and can only be perfectly accomplished by a plastic surgeon that has many years of experience in rhinoplasty under his belt.
There are two approaches for rhinoplasty; open approach and closed approach. Many experienced surgeons prefer the open approach as it affords complete exposure of the nasal bones, leading to an accurate diagnosis of all the potential causes of either the nasal airway obstruction or the cause of the cosmetic deformity. Moreover, precise manipulation of the different structures can be accomplished and the dynamic interplay between these structures appreciated, giving marvelous results. The use of the open approach is recommended in three main circumstances: posttraumatic deformities, where complete release of all intrinsic and extrinsic deforming forces is necessary, secondary or revisional rhinoplasty, when complex nasal tip modifications are necessary.
The closed approach is the perfect choice for patients who have an isolated nasal dorsal hump deformity or whenever there is minimal change needed to modify the tip of the nose. Choosing the right rhinoplasty approach is a key factor in the reproducibility and success of your rhinoplasty.
Dr Jay Calvert is a Board certified Plastic Surgeon who specializes in rhinoplasty. You are always welcome to schedule a consultation with him to discuss a rhinoplasty procedure. Dr Calvert's experience in all rhinoplasty approaches and his wise analysis of your nosfacial structures will sure guarantee outmost success of the procedure.
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